In medical ethics, business ethics, and some branches of political philosophy (multi-culturalism, issues of just allocation, and equitable distribution) the literature increasingly combines insights from ethics and the social sciences. Some authors in medical ethics even speak of a new phase in the history of ethics, hailing "empirical ethics" as a logical next step in the development of practical ethics after the turn to "applied ethics." The name empirical ethics is ill-chosen because of its associations with "descriptive ethics." Unlike descriptive (...) ethics, however, empirical ethics aims to be both descriptive and normative. The first question on which I focus is what kind of empirical research is used by empirical ethics and for which purposes. I argue that the ultimate aim of all empirical ethics is to improve the context-sensitivity of ethics. The second question is whether empirical ethics is essentially connected with specific positions in meta-ethics. I show that in some kinds of meta-ethical theories, which I categorize as broad contextualist theories, there is an intrinsic need for connecting normative ethics with empirical social research. But context-sensitivity is a goal that can be aimed for from any meta-ethical position. (shrink)

In this book G. A. Cohen examines the libertarian principle of self-ownership, which says that each person belongs to himself and therefore owes no service or product to anyone else. This principle is used to defend capitalist inequality, which is said to reflect each person's freedom to do as as he wishes with himself. The author argues that self-ownership cannot deliver the freedom it promises to secure, thereby undermining the idea that lovers of freedom should embrace capitalism and the inequality (...) that comes with it. He goes on to show that the standard Marxist condemnation of exploitation implies an endorsement of self-ownership, since, in the Marxist conception, the employer steals from the worker what should belong to her, because she produced it. Thereby a deeply inegalitarian notion has penetrated what is in aspiration an egalitarian theory. Purging that notion from socialist thought, he argues, enables construction of a more consistent egalitarianism. (shrink)

Within the context of applied bioethical reasoning, various conceptions of the human body are focused upon by the author in relation to normative notions of autonomy.

The current system of organ procurement which relies on donation is inadequate to the current and future need for transplantable kidneys. The growing disparity between demand and supply is accompanied by a steep human cost. I argue that a regulated market in organs from living vendors is the only plausible solution, and that objections common to opponents of organ markets are defeasible. I argue that a morally defensible market in kidneys from living vendors includes four characteristics: (1) the priority of (...) safety for both vendors and recipients, (2) transparency regarding the risks to vendors and recipients, (3) institutional integrity regarding guidelines for cooperating with kidney vendors, and (4) operation under a rule of law. I conclude with some remarks on remaining problems with this account, and offer some suggestions as to how these problems might be addressed. (shrink)

The development of bioethics primarily at the cognitive level further perpetuates the tendency to construe all aspects of our lives, including our bodies, as technical systems. For example, if we consider the moral issue of organ sales without taking our embodiment into account, there appear to be no sound arguments for opposing such sales. However, it is important to consider the aspects of the phenomenal body that challenge rational deliberation by exploring an embodied approach to the ethical dilemma produced by (...) a proposed kidney exchange as presented in one of Krzysztof Kieslowski's Dekalog films. What is sought is a description of a body-measure that would serve as a critique of strictly cognitive bioethical deliberations. (shrink)

: Debates about commodification in bioethics frequently appeal to Kant's famous second formulation of the categorical imperative, the formula requiring us to treat the rational (human) being as "an end in itself" and "never as a means only." In the course of her own treatment of commodification, Margaret Jane Radin observes that Kant's application of this formula "does not generate noncontroversial particular consequences." This is so, I argue, because Kant offers three different--and largely incompatible--interpretations of the formula. One focuses on (...) the obligation to preserve rational willing; the second stresses respect for human (physical) dignity and integrity; the third views respect for others as "ends in themselves" as primarily involving a willingness to govern one's conduct by a procedure of impartial co-legislation. Only the third of these interpretations, I conclude, offers a reasonable and coherent approach to moral judgment about the limits of commodification. (shrink)

_Bodies for Sale: Ethics and Exploitation in the Human Body Trade _explores the philosophical and practical issues raised by activities such as surrogacy and organ trafficking. Stephen Wilkinson asks what is it that makes some commercial uses of the body controversial, whether the arguments against commercial exploitation stand up, and whether legislation outlawing such practices is really justified. In Part One Wilkinson explains and analyses some of the notoriously slippery concepts used in the body commodification debate, including exploitation, harm and (...) consent. In Part Two he focuses on three controversial issues outlining contemporary regulation and investigating both the moral issues and the arguments for legal prohibition. (shrink)

While there are numerous doubts, controversies and lack of consensus on alternative definitions of human death, it is argued that it is more ethical to allow people to choose either cessation of cardio-respiratory function or loss of entire brain function as the definition of death based on their own views. This paper presents the law of organ transplantation in Japan, which allows people to decide whether brain death can be used to determine their death in agreement with their family. Arguably, (...) Japan could become a unique example of individual choice in the definition of death if the law is revised to allow individuals choose definition of death independently of their family. It suggests that such an approach is one of the reasonable policy options a country can adopt for legislation on issues related to the definition of death. (shrink)

: Free-market libertarians have long supported incentives to increase organ procurement, but those oriented to justice traditionally have opposed them. This paper presents the reasons why those worried about justice should reconsider financial incentives and tolerate them as a lesser moral evil. After considering concerns about discrimination and coercion and setting them aside, it is suggested that the real moral concern should be manipulation of the neediest. The one offering the incentive (the government) has the resources to eliminate the basic (...) needs that pressure the poor into a willingness to sell. It is unethically manipulative to withhold those resources and then offer payment for organs. Nevertheless, the poor have been left without basic necessities for 20 years since the passage of the prohibition on incentives. As long as the government continues to withhold a decent minimum of welfare, liberals should, with shame, cease opposing financial incentives for organ procurement. (shrink)

"Whole brain death" (neurological death) is well-established as a legal standard of death across the country. Recently, New Jersey became the first state to enact a statute recognizing a personal religious exemption (a conscience clause) protecting the rights of those who object to neurological death. The Act also mandates adoption through the regulatory process of uniform and up-to-date clinical criteria for determining neurological death.

Positions on the ethics of human enhancement technologies can be (crudely) characterized as ranging from transhumanism to bioconservatism. Transhumanists believe that human enhancement technologies should be made widely available, that individuals should have broad discretion over which of these technologies to apply to themselves, and that parents should normally have the right to choose enhancements for their children-to-be. Bioconservatives (whose ranks include such diverse writers as Leon Kass, Francis Fukuyama, George Annas, Wesley Smith, Jeremy Rifkin, and Bill McKibben) are generally (...) opposed to the use of technology to modify human nature. A central idea in bioconservativism is that human enhancement technologies will undermine our human dignity. To forestall a slide down the slippery slope towards an ultimately debased ‘posthuman’ state, bioconservatives often argue for broad bans on otherwise promising human enhancements. This paper distinguishes two common fears about the posthuman and argues for the importance of a concept of dignity that is inclusive enough to also apply to many possible posthuman beings. Recognizing the possibility of posthuman dignity undercuts an important objection against human enhancement and removes a distortive double standard from our field of moral vision. (shrink)

Proposals to compensate families for transplantable organs are gathering momentum. These proposals assume that the body is not integral to the self—that it can be treated like property. Most people believe otherwise.

We not only own our bodies, we are our bodies. Can we simply alienate parts of them? Both a theology of stewardship and the principle of self‐ownership would seem to permit or even encourage us to do this.

There are not many international consensuses in the governance of biomedicine. One that exists concerns a general reluctance toward a commercialization of organ procurement. However, with reference to the problem of there is an increasingly louder call in ethical and legal discourse to and to establish a debate on financial incentives Other ethicists and jurists criticize this development, and warn of injustice, exploitation of the poor, and a commodification of the human body.

The human body is becoming hot property, a resource to be “mined,” “harvested,” patented, and traded commercially for profit as well as scientific and therapeutic advances. Under the new entrepreneurial approach to the body old tensions take on new dimensions—about consent, the fair distribution of tissues and products developed from them, the individual and cultural values represented by the body, and public policy governing the use of organs and tissues.

This essay deals with property rights in body parts that can be exchanged in a market. The inquiry arises in the following context. With some exceptions, the laws of many countries permit only the donation, not the sale, of body parts. Yet for some years there has existed a shortage of body parts for transplantation and other medical uses. It might then appear that if more sales were legally permitted, the supply of body parts would increase, because people would have (...) more incentive to sell than they currently have to donate. To allow sales is to recognize property rights in body parts. To allow sales, however, makes body parts into “commodities”—that is, things that can be bought and sold in a market. And some view it as morally objectionable to treat body parts as commodities. (shrink)